Psychiatry job market in the DC/Virginia/Maryland metro area

[Mark7954]

Hello

I am a graduating PGY-4 moving to the DMV after graduation interested in general outpatient psychiatry. I wanted to know if anyone has familiarity with the psychiatry job market/culture in the DMV area? Overly saturated? Comments on PP vs community? Any career advice would help! Thanks

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[ObsequiousAplomb]

I've been in solo private practice in the area for coming up on two years now. It's a pretty saturated market unless you take insurance. All the insurances are desperate, just not desperate enough to pay well.there are plenty of jobs to be found at the hospitals. They don't pay particularly well.

 

[Mark7954]

I've been in solo private practice in the area for coming up on two years now. It's a pretty saturated market unless you take insurance. All the insurances are desperate, just not desperate enough to pay well.there are plenty of jobs to be found at the hospitals. They don't pay particularly well.

Thank you so much for sharing your experience:

When you say the market is saturated, do you mean there’s an oversupply of psychiatrists, or that patients are mostly looking for insurance-based care? Have you found any strategies that work for a cash-pay model?


Are you seeing any opportunities for hybrid models, where a psychiatrist takes insurance for some patients and keeps a portion of their practice cash-pay? Or is the demand mostly for in-network providers?

When you say insurances don’t pay well, do you mean the rates are too low to make private practice sustainable, or is it more about administrative burdens and slow reimbursement?

Thanks again

 

[ObsequiousAplomb]

Thank you so much for sharing your experience:

When you say the market is saturated, do you mean there’s an oversupply of psychiatrists, or that patients are mostly looking for insurance-based care? Have you found any strategies that work for a cash-pay model?


Are you seeing any opportunities for hybrid models, where a psychiatrist takes insurance for some patients and keeps a portion of their practice cash-pay? Or is the demand mostly for in-network providers?

When you say insurances don’t pay well, do you mean the rates are too low to make private practice sustainable, or is it more about administrative burdens and slow reimbursement?

Thanks again

I take one insurance, about 15 months now. I have about 80 insurance patients. I also have ~10 steady private pay patients. I've seen 200 people for consultations in the first year. I work ~12 hours per week. So yeah, plenty of people do something hybrid.

There are plenty of people charging $1100/hour private pay and plenty of people charging $200 and everything in between.

The market is saturated with psychiatrists. It's also saturated with NPs and PAs. The telehealth companies are also pretty active in the area, so there's competition from outside of the area too.

My insurance pays roughly:

99214: $140
99213: $100
90833: $80
90836: $100
90838: $130
90792: $210

Without ever really following up on claims or anything at all really, the insurance has paid out about 92% of the money from the claims I've submitted so far. So that's nice.

 

[calvnandhobbs68]

I take one insurance, about 15 months now. I have about 80 insurance patients. I also have ~10 steady private pay patients. I've seen 200 people for consultations in the first year. I work ~12 hours per week. So yeah, plenty of people do something hybrid.

There are plenty of people charging $1100/hour private pay and plenty of people charging $200 and everything in between.

The market is saturated with psychiatrists. It's also saturated with NPs and PAs. The telehealth companies are also pretty active in the area, so there's competition from outside of the area too.

My insurance pays roughly:

99214: $140
99213: $100
90833: $80
90836: $100
90838: $130
90792: $210

Without ever really following up on claims or anything at all really, the insurance has paid out about 92% of the money from the claims I've submitted so far. So that's nice.

I mean averaging 350-400/hr isn't bad. It's not $1000/hr and it's probably annoying you're in an area where you've got "consultants" charging 500/hr but it's certainly comfortable.

 

[ObsequiousAplomb]

I mean averaging 350-400/hr isn't bad. It's not $1000/hr and it's probably annoying you're in an area where you've got "consultants" charging 500/hr but it's certainly comfortable.

that's why I keep doing it. If I expand beyond the 3 half days that I'm doing right now, I feel like I'll need to hire someone to answer phones and manage the schedule and all that. Unclear whether a billing service would be helpful if I'm already collecting 92%+.

The other insurances offered about 20% less than this one.

 

[Stagg737]

that's why I keep doing it. If I expand beyond the 3 half days that I'm doing right now, I feel like I'll need to hire someone to answer phones and manage the schedule and all that. Unclear whether a billing service would be helpful if I'm already collecting 92%+.

The other insurances offered about 20% less than this one.

At 92% it's probably not worth it to pay someone 2-5% of your collections to add roughly that to your collections.

 

[ObsequiousAplomb]

At 92% it's probably not worth it to pay someone 2-5% of your collections to add roughly that to your collections.

I was imagining that the 8% would somehow expand the more insurances I take and the larger the volume I see if I were to expand beyond 7-12 hours per week. Though I can't imagine billing services collect much more than that?

 

[Stagg737]

I was imagining that the 8% would somehow expand the more insurances I take and the larger the volume I see if I were to expand beyond 7-12 hours per week. Though I can't imagine billing services collect much more than that?

I would imagine that if you're looking to expand significantly to a FT practice then I imagine it would, but I'd defer to someone like TexasPhysician, Clause, or Sushi who has more experience building outpatient practices. I was more referring to if you were just keeping the small OP side practice and expanding another half day or adding one other payor.

 

[Ellomate]

I've been in solo private practice in the area for coming up on two years now. It's a pretty saturated market unless you take insurance. All the insurances are desperate, just not desperate enough to pay well.there are plenty of jobs to be found at the hospitals. They don't pay particularly well.

Any specific number for hospital jobs that don't pay well?

 

[ObsequiousAplomb]

Any specific number for hospital jobs that don't pay well?

$215k-250k for most of the typical inpatient gigs. Some of the less desirable ones pay upwards of $370k though.

 

[FlowRate]

It's the only Kaiser region that I wouldn't consider. (Only one that does 20/40 instead of 30/60.)

 

[littlefred]

It's the only Kaiser region that I wouldn't consider. (Only one that does 20/40 instead of 30/60.)

They do 30/60.

 

[FlowRate]

They do 30/60.

Since when? I verified this with their leadership within the last month or two. And it's been the case for a while--one of my colleagues started there like 10 years ago and it was true then, as well.

 

[ObsequiousAplomb]

It's the only Kaiser region that I wouldn't consider. (Only one that does 20/40 instead of 30/60.)

What does 20/40 vs 30/60 mean?

 

[Stagg737]

What does 20/40 vs 30/60 mean?

Probably f/up vs new patient times.

 

[FlowRate]

Probably f/up vs new patient times.

This.

 

[littlefred]

Since when? I verified this with their leadership within the last month or two. And it's been the case for a while--one of my colleagues started there like 10 years ago and it was true then, as

Over a year now. I know this first hand.

 

[FlowRate]

Over a year now. I know this first hand.

Thanks, that's really good to know that all regions are aligned now. (Actually, HI gets 90 min for news.) The confirmation I got was second hand through the HP leader here contacting the one there, so makes sense that they wouldn't have been aware of the update in PMG scheduling.